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ED Management: the Monthly Update on Emergency Department Management

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https://www.readbyqxmd.com/read/29763536/institute-a-thorough-process-to-manage-payer-audits
#1
Caral Edelberg
No abstract text is available yet for this article.
June 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29763535/team-based-pod-system-reduces-lengths-of-stay-for-treat-and-release-patients
#2
Nicholas Gavin, Kathy Peterson
To boost performance on a range of metrics, the 55-bed ED at NYU Lutheran Medical Center in Brooklyn, NY, transitioned to a pod system in August 2016. The approach, which is designed to foster team-based care, involves assigning physicians and nurses to designated geographic areas throughout the day, minimizing the movement of physicians as well as the need for phone communication. When coupled with other changes, including the introduction of point-of- care testing, the pod initiative has enabled the ED to reduce lengths of stay for all treat-and-release patients to less than three hours for the first time in the history of the department, according to administrators...
June 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29763534/health-systems-turn-to-communication-and-resolution-programs-to-identify-errors
#3
Richard Boothman, Thomas Gallagher, Alan Woodward
No abstract text is available yet for this article.
June 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29763533/assessing-risk-for-future-firearms-violence-in-young-people-who-present-to-ed
#4
(no author information available yet)
A new clinical index tool designed specifically for the emergency environment predicts the risk for future firearms violence in young people 14-24 years of age. The approach employs a brief, 10-point instrument that can be administered in one to two minutes, according to investigators. They also note that while the tool is based on data from a single ED in Flint, Ml, the tool should be applicable to urban EDs in regions that have similar characteristics. To create the tool, investigators used data from the Flint Youth Injury Study, an investigation of a group of patients 14-24 years of age who reported using drugs in the previous six months and accessed care at a Level I trauma center...
June 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29763532/palliative-care-occupies-growing-presence-in-ed
#5
(no author information available yet)
As the benefits of palliative care become more evident in clinical trials, there is growing interest in making such resources available to patients at an earlier stage, such as the ED. However, experts note that emergency staff first must identify available resources and make sure that providers have the primary palliative care skills needed to effectively introduce the topic to appropriate patients and families. Research shows that initiating the call for a palliative care consult while the patient is in the ED can deliver quality-of-life benefits even three months later...
June 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29160985/emergency-medicine-stakeholders-voice-priorities-for-healthcare-reform-urge-individual-clinicians-to-get-involved
#6
Rebecca Parker, Karen Wiley
With President Trump and congressional Republicans promising to repeal or replace parts of the entirety of the Affordable Care Act (ACA), emergency medicine stakeholders are making sure lawmakers know what provisions in the law must remain intact, and what new reforms are needed. They also are urging emergency medicine clinicians to stay informed on the issues, and to advocate for their interests. The American College of Emergency Physicians (ACEP) wants to ensure that emergency services remain essential covered benefits, and that freestanding EDs and other emerging healthcare delivery models are supported...
April 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29160984/in-search-of-effective-solutions-to-curb-workplace-violence
#7
Judith Arnetz, Jane Lipscomb, Joanne Ogaitis
Investigators have applied epidemiological principles to the study of workplace violence, producing results that offer intriguing information to hospitals struggling for a way forward on this issue. In a randomized, to hospitals struggling for a wary forward on this issue. In a randomized, controlled trial, the researchers found that a one-time, unit-based intervention can reduce the incidence of violent events, and that the approach offers some lasting effect over time. The intervention consisted of a 45-minute discussion with unit supervisors in which unit-specific data regarding violent incidents in their workplace were shared along with an array of improvement strategies...
April 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29160983/eds-report-strong-surges-in-flu-related-volume-straining-capacity-in-some-regions
#8
David Burmeister, Mohamud Daya, Christopher Sampson
With influenza season intensifying, many EDs report strong surges in flu related volume. Although illness severity does not appear to be atypical, hospitals that see high numbers of older patients and the chronically ill face extra challenges meeting the needs of patients who have added susceptibility to flu-related complications. Experts note that all flu strains circulating this year appear to be sensitive to antiviral medications. In mid-February, the CDC reported the number of flu cases was still on the increase in most regions of the country, with 28 states reporting a high incidence of influenza-like illness...
April 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29211411/using-telemedicine-to-address-crowding-in-the-ed
#9
Benjamin Guss, David Mishkin, Rahul Sharma
Some health systems are piloting telemedicine solutions in the ED to address crowding and decrease patient wait times. One new program, implemented at the Lisa Perry Emergency Center at New York Presbyterian (NYP) Weill Cornell Medical Center in New York, involves offering low-acuity patients the option of visiting an off-site physician via telemedicine hookup. Administrators note that the approach can get patients in and out of the ED within 30 minutes, and patients have thus far been highly satisfied with the approach...
November 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29211410/pushing-the-envelope-on-stemi-response
#10
J Lee Garvey, Christopher Granger, W Frank Peacock
New findings from the Mission: Lifeline STEMI Systems Accelerator program suggest that a regionalized approach to ST-segment elevation myocardial infarctions (STEMI) can cut time-to-treatment for patients modestly, thereby improving the prospects for better outcomes. The approach encourages hospitals, emergency medical services (EMS) and cardiologists in a region to work together to optimize treatment and efficiency so that patients in need of percutaneous coronary intervention (PCI) receive this care more expeditiously...
November 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29215224/magnified-bacteria-powerful-motivator-for-hand-hygiene-compliance
#11
Ashley Gregory
Infection prevention specialists at Henry Ford Hospital in Detroit have found that showing healthcare workers magnified pictures of bacteria found ontheir hands and in their surrounding units can be a powerful motivator for improved hand hygiene compliance. When tested in four units during a one-month period, the intervention boosted hand hygiene compliance by an average of 24%. Investigators note that to be successful, the intervention must be paired with an effective compliance monitoring program. For the study, investigators visited each unit twice per week, during which they would swab various items as well as employees' hands using and adenosine triphosphate (ATP) meter, a hand-held device that measures living organisms...
August 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29211415/education-creates-welcoming-environment-for-transgender-patients
#12
Jesse Ehrenfeld, Samantha Gridley
The ED often is the access point of choice for transgender patients who may be reluctant to interact with providers. Experts say there is a need for training and education of how to present a gender-affirming healthcare environment. Recommended steps include a review of policies, along with corresponding changes to electronic and paper intake forms to ensure that the language used is inclusive of all genders. While blanket discrimination may be declining, experts note that some providers are uncertain about how to interact with a transgender patient...
August 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29211414/training-drills-pivotal-in-mounting-response-to-orlando-shooting
#13
Eric Albert, Timothy Bullard
Emergency providers at Orlando Regional Medical Center in Orlando. FL, faced multiple challenges in responding to the worst mass shooting in U.S. history. As the scene of the shooting was only three blocks away from the hospital, there was little time to prepare when notified that victims would begin arriving shortly after 2 a.m. on June 12. Also, fears of a gunman near the hospital briefly put the ED on lock down. However, using the incident command system, the hospital was able to mobilize quickly, receiving 44 patients, nine of whom died shortly after arrival...
August 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27439227/ed-based-counseling-sessions-reduce-risky-opioid-use-among-certain-patients
#14
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Investigators at the University of Michigan have shown promising results from an ED-based intervention designed to curb risky opioid use among patients who have reported opioid misuse within the previous three months. The intervention includes a 30-minute counseling session with a therapist who utilizes motivational interviewing techniques to strengthen their desire to move away from opioid use behaviors. The randomized clinical trial included 204 emergency patients, divided between patients receiving printed educational materials and patients receiving printed materials as well as counseling sessions...
July 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27439226/fresh-approach-for-critically-ill-patients-with-time-sensitive-needs
#15
(no author information available yet)
To meet the needs of critically ill patients with time-sensitive needs, the University of Maryland Medical Center (UMMC) created the Critical Care Resuscitation Unit (CCRU), a six-bed, short-stay ICU designed to accelerate care to resource-heavy patients who require immediate evaluation and treatment. The CCRU is modeled after UMMC's trauma resuscitation unit, but with resources and staff geared toward non-trauma, critically ill patients, many of whom require life-saving care. The unit is largely staffed by emergency providers who have undergone additional training in critical care...
July 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27439225/take-a-multidisciplinary-team-based-approach-on-elder-abuse
#16
(no author information available yet)
While EDs are well positioned to identify incidents of elder abuse, providers often miss the opportunity. Experts say providers find only one in every 24 cases, and that the pendulum must swing toward over-detection. Investigators acknowledge elder abuse is difficult to confirm, given that disease processes can explain some of the signs. Further, older adults are often reluctant to report abuse because they fear they will be removed from their homes or separated from their caregivers. Given the complexity involved with addressing the issue, investigators recommend EDs establish a multidisciplinary approach to the problem...
July 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27295820/tackling-disrespectful-unprofessional-provider-behaviors
#17
(no author information available yet)
To address problematic provider behaviors that can affect patient safety, physician leaders at Vanderbilt University Medical Center (VUMC) developed the Coworker Observation Reporting System (CORS), a systematized approach for retrieving and addressing concerns about providers reported by staff. To encourage staff members to report concerns, they have to trust that the organization is going to respond, and they also have to feel that they have a certain element of psychological safety. Selected peer messengers share staff complaints with providers, enabling them to offer their perspectives on the issues or events in question...
June 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27295819/advance-care-planning-with-and-without-an-annual-wellness-visit
#18
Caral Edelberg
No abstract text is available yet for this article.
June 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27295818/new-tool-improves-processes-streamlines-operations
#19
(no author information available yet)
A one-page tool has shown promise for facilitating shared decision-making between clinicians and patients who present to the ED with low-risk chest pain. The tool, dubbed Chest Pain Choice, was developed by researchers at the Mayo Clinic. It is designed to more effectively communicate risk to patients so that they can make more informed decisions with their providers regarding treatment options. Investigators devised a study involving 898 low-risk chest pain patients in six EDs in five states. Half the patients were randomized to standard physician consultations and half received consultations facilitated by the Chest Pain Choice tool...
June 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27295817/innovative-program-targets-five-common-pain-syndromes-with-non-opioid-alternatives
#20
(no author information available yet)
To combat the prescription opioid problem, St. Joseph's Healthcare System in Paterson, NJ, has developed a new program that gives providers options they can use to effectively alleviate pain without resorting to highly addictive medication. Launched in January 2016 in the ED at St. Joseph's Regional Medical Center (SJRMC), the Alternatives to Opioids (ALTO) program utilizes protocols that primarily target five common conditions: renal colic, sciatica, headaches, musculoskeletal pain, and extremity fractures...
June 2016: ED Management: the Monthly Update on Emergency Department Management
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